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AKT > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is chondrodermatitis nodularis helicis?

A

Painful nodule on the ear

Benign

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2
Q

Management of chondrodermatitis nodularis helicis

A

Reduce pressure on the ear - foam ear protectors during sleep

cryotherapy, steroid injection, collagen injection

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3
Q

Causes of acanthosis nigricans

A 
T2DM
GI cancer
Obesity
PCOS
acromegaly
Cushing's disease
Hypothyroidism
Prader-Willi
Combined oral contraception
Nicotinic acid
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4
Q

What can be a consequence of long term antibiotic use in acne vulgaris?

A

gram negative folliculitis

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5
Q

Management of gram negative folliculitis

A

high dose oral trimethoprim

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6
Q

Why is minocycline no longer used for acne vulgaris?

A

irreversible pigmentation

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7
Q

What is the difference between scarring and non-scarring alopecia?

A

Scarring = destruction of hair follicle

Non-scarring = preservation of hair follicle

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8
Q

Causes of scarring alopecia

A 
trauma, burns
radiotherapy
lichen planus
discoid lupus
tinea capitis
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9
Q

Causes of non-scarring alopecia

A 
male-pattern baldness
iron and zinc deficiency
alopecia areata
telogen effluvium
trichotillomania
drugs
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10
Q

What drugs cause allopecia?

A 
cytotoxic drugs
carbimazole
heparin
oral contraceptive pill
colchicine
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11
Q

Cause of alopeia areata

A

Autoimmune hair loss

non-scarring

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12
Q

Features of alopecia areata

A

Demarcated patches of hair loss

“exclamation mark” hairs

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13
Q

Outcome of alopecia areata

A

50% patients regrow hair by 1 year

80-90% regrow hair eventually

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14
Q

Treatment for alopecia areata

A

Topical or intralesoinal steroids
Topical minoxidil
Phototherapy
Wigs

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15
Q

How do antihistamines work?

A

H1 inhibitors

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16
Q

Examples of sedating antihistamines

A

Chlorpheniramine

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17
Q

Non-sedating antihistamines

A

Loratidine

Cetirizine

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18
Q

Medical name for athlete’s foot

A

Tinea pedis

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19
Q

Management of athlete’s foot

A

Topical imidazole

Topical terbinafine

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20
Q

How does atopic eruption of pregnancy present?

A

Ecematous, itchy, red rash

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21
Q

What is the commonest skin disorder in pregnancy?

A

Atopic eruption of pregnancy

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22
Q

What is melasma?

A

Hyperpigmented macules in sun exposed areas

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23
Q

Causes of melasma

A

Pregnancy

combined oral contraceptive pill

hormone replacement therapy

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24
Q

What are milia?

A

Small benign keratin filled cysts typically found on the face

More common in newborns

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25
Q

What are salmon patches?

A

Pink, blotchy vascular birthmark on new borns

Fade over a few months

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26
Q

Management of periorificial dermatitis

A

topical or oral antibiotics

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27
Q

Nail changes seen in psoriasis

A

Pitting
Oncholysis
Subungual hyperkeratosis
Loss of the nail

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28
Q

What is a keratoacanthoma?

A

Benign epithelial tumour

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29
Q

Features of a keratoacanthoma

A

Look like a volcano or crater

Initially smooth dome shaped papule
Becomes crater centrally filled with keratin

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30
Q

Management of keratoacanthoma

A

Urgent excision as difficult to differentiate clinically from SCC

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31
Q

What is granuloma annulare?

A

Papular lesion slightly pigmented and depressed centrally

Found on dorsal of hand and feet

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32
Q

Management options for hyperhidrosis

A

1st line = Topical aluminium chloride

Iontophoresis
Botox
Surgery e.g. endoscopic transthoracic sympathectomy

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33
Q

Causes of onycholysis

A 
Trauma
Infection - esp fungal
Psoriasis, dermatitis
Raynaud's
Hyper and hypo thyroidism
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34
Q

How to diagnosis nickel dermatitis?

A

Skin patch test

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35
Q

Vaccination against primary varicella

A

Live attenuated vaccine

For healthcare workers who are not already immune and contacts of immunocompromised patients

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36
Q

Shingles vaccine

What type of vaccine is it?
Who gets it?

A

Live attenuated, sub cut

Patients age 70-79

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37
Q

Management of leukoplakia

A

Biopsy to exclude squamous cell carcinoma

Regular follow up to check for malignant transformation

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38
Q

When are systemic side effects seen from potent topical steroids?

A

Applied to >10% body surface areas

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39
Q

How long to use potent steroids for?

A

8 weeks

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40
Q

How long to use very potent steroids for?

A

4 weeks

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41
Q

Side effects of topical steroids

A

Skin atrophy
Striae
Rebound symptoms

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42
Q

Can vitamin D analogues be used long term?

A

Yes

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43
Q

Effect of vitamin D on the psoriasis plaque

A

Reduce scale and thickness but not the erythema

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44
Q

Can you use vitamin D analogues for psoriasis in pregnancy?

A

no

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45
Q

Side effects of dithranol used in psoriasis

A

Burning

Staining

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46
Q

Side effects of phototherapy

A

Ageing

Squamous cell skin cancer

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47
Q

Phototherapy for psoriasis

A

narrow band UVB

photochemotherapy= psoralen + ultraviolet A light (PUVA)

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48
Q

Psoriasis - criteria for non-biological systemic therapy

A
  • Can’t be controlled with topical therapy
  • Significant impact on wellbeing

+ ONE OF:

  • Psoriasis is extensive
  • Localised with significant functional impairment/distress
  • Phototherapy ineffective
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49
Q

First line systemic therapy agent for psoriasis

A

Methotrexate

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50
Q

When is ciclosporin used over methotrexate in psoriasis?

A

Rapid or short term disease control

Palmoplantar pustulosis

Considering conception (men and women)

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51
Q

Second line systemic therapy agent for psoriasis

A

ciclosporin

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52
Q

Criteria for biological therapy in psoriasis

A

Failed trial of methotrexate, ciclosproin and PUVA

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53
Q

Effectiveness of oral retinoids for acne

A

2/3 have long term remission or cure

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54
Q

Side effects of oral retinoids

A 
Teratogen
Dry skin, eyes, lips/mouth
Low mood
Raised triglycerides
Hair thinning
Nose bleeds
Intracranial hypertension
Photosensitivity
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55
Q

What is the most common side effect of oral retinoids?

A

Dry skin, eyes, lips and mouth

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56
Q

Why should you not combine oral retinoids with tetracyclines?

A

both increase the risk of intracranial hypertension

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57
Q

Causes of erythema nodosum

A 
Infection = strep, TB
Sarcoidosis
IBD
Behcet's
Malignancy/lymphoma
Drugs = penicillin, sulphonamides, contraceptive pill
Pregnancy
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58
Q

Drug causes of urticaria

A

Aspirin
Penicillins
NSAIDs
Opiates

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59
Q

Management of urticaria

A

Non-sedating antihistamines

Prednisolone in severe or resistent cases

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60
Q

Which is the most common type of contact dermatitis?

A

Irritant contact

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61
Q

Irritant contact dermatitis - causes

A

Detergents

Cement

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62
Q

Irritant contact dermatitis - presentation

A

On the hands
Erythema typical
Crusting/vesicles rare

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63
Q

Allergic contact dermatitis - causes

A

Hair dyes

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64
Q

Allergic contact dermatitis - presentaiton

A

Acute weeping eczema

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65
Q

Which type of skin cancer tends to be found in scar tissue?

A

Squamous cell carcinoma

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66
Q

Spider naevi associations

A

Liver disease
Pregnancy
Combined oral contraceptive pill

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67
Q

Polymorphic eruption of pregnancy - features

A

Generally third trimester
Pruritic eruption
Lesions in abdominal striae

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68
Q

Polymorphic eruption of pregnancy - management

A

Emollients
Mild potency topical steroids
Oral steroids

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69
Q

Pemphigoid gestationis - features

A

Pruritic blistering lesions
Peri-umbilical region then spreading
2nd and 3rd trimester

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70
Q

Pemphigoid gestationis - management

A

oral corticosteroids

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71
Q

What is hirsutism?

A

Androgen dependent hair growth in women

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72
Q

What is hypertrichosis?

A

Androgen independent hair growth

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73
Q

Causes of hirsutism

A 
PCOS
Cushing's
Congential adrenal hyperplasia
Androgen therapy
Obesity
Adrenal tumour
Androgen secreting ovarian tumour
Phenytoin
Corticosteroids
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74
Q

Most common cause of hirsutism

A

PCOS

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75
Q

How is hirsutism assessed?

A

Ferriman-Gallwey scoring system

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76
Q

Management of hirsutism

A

Weight loss
Cosmetic techniques waxing/bleaching
Oral contraceptive pill
For facial hirsutism - topical eflornithine

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77
Q

Causes of hypertrichosis

A

Drugs = minoxidil, ciclosporin, diazoxide

Congenital
Porphyria cutanea tarda
Anorexia nervosa

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78
Q

Cause of eczema herpeticum

A

Herpes simplex 1 or 2

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79
Q

Management of eczema herpeticum

A

Admit for IV aciclovir

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80
Q

Which burns to refer to secondary care?

A

Deep and full thickness
Superficial burns >3% TBSA in adults or 2% in children
Superficial burns involving face hands perineum genitals or any flexure
Circumferential burns
Inhalation injury
Electrical or chemical burn
Suspicion of non-accidental injury

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81
Q

Features of discoid eczema

A

Round or oval plaques
Extremely itchy
On the extremities

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82
Q

What is 1 finger tip unit?

A

0.5g

Sufficient to treat a skin area about twice that of a flat adult hand

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83
Q

Example of a mild potency steroid

A

Hydrocortisone 0.5-2.5%

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84
Q

Example of a moderate potency steroid

A

Betamethasone valerate 0.025% (betnovate RD)

Clobetasone butyrate 0.05% (eumovate)

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85
Q

Example of a potent steorid

A

Fluticasone propionate 0.05% (cutivate)

Betametasone valerate 0.1% (betnovate)

Betametasone dipropionate 0.05% (diprosone)

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86
Q

Example of a very potent steroid

A

Clobetasone proprionate 0.05% (dermovate)

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87
Q

Treatment of a plantar wart

A

Salicyclic acid 1-50% applied daily for 12 weeks

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88
Q

What is first line contraception for management of acne?

A

Microgynon

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89
Q

What is second line contraception for management of acne?

A

Dianette

Don’t continue once acne controlled for 3 months

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90
Q

Drugs that exacerbate psoriasis

A 
Beta blockers
Lithium
Antimalarials
NSAIDs
ACE-I
infliximab
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91
Q

What is a venous lake?

A

Angioma on the lip

No treatment needed unless wanted for cosmetic reasons

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92
Q

Skin disorders associated with SLE

A

Photosensitive ‘butterfly’ rash
Discoid lupus
Alopecia
Livedo recitularis

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93
Q

Investigations for allergic contact dermatitis

A

Patch testing

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94
Q

Causes of skin bullae

A 
Epidermolysis bullosa (congenital)
Bullous pemphigoid
Pemphigus
Insect bite
Trauma/friction
Furosemide
Barbiturates
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95
Q

What is dermatitis artefacta?

A

Self inflicted skin lesions, patients deny that they are self induced

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96
Q

Features of dermatitis artefacta

A

Linear/geometric depending on cause
E.g. scratching, deodorant spray, inhaler
Appear suddenly
Commonly face or hands
Patients are non-chalant “la belle indifference”

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97
Q

What causes the itching in scabies?

A

Delayed type IV hypersensitivity reaction to mites laying eggs
30 days after initial infection

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98
Q

Scabies - features

A

Widespread pruritis
Linear burrows
In infants - face and scalp

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99
Q

1st line management for scabies

A

Permethrin 5%

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100
Q

2nd line management for scabies

A

Malathion 0.5%

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101
Q

Directions to give to patients about applying scabies treatment

A

Apply to all areas
Allow to dry for 8-12 hours for permethrin or 24 hours for malathion, then wash off
Repeat after 7 days
All of household treated

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102
Q

How long does pruritis last in scabies?

A

4-6 weeks after treatment

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103
Q

Causes of erythroderma

A 
Eczema
Psoriasis
Drugs - e.g. gold
Lymphoma, leukaemia
Idiopathic
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104
Q

Drug causes of lichen planus

A

Gold
Quinine
Thiazides

105
Q

Lichen planus - features

A

Itchy, papular rash
“white lines” pattern on surface
Koebner phenomena
Oral involvement in 50%

106
Q

What is koebner phenomena?

A

new lesions at site of trauma

107
Q

What is vitiligo?

A

Autoimmune condition leading to loss of melanocytes and depigmentation of the skin

108
Q

Vitiligo - associated conditions

A 
T1DM
Addison's disease
Autoimmune thyroid disorders
Pernicious anaemia
Alopecia areata
109
Q

Vitiligo - features

A

Well demarcated patches of depigmented skin

Peripheries most affected

Koebner phenomena

110
Q

Vitiligo - management

A

Sunblock
Camoflague make up
Topical steroids may reverse changes if applied early

111
Q

Main cause of fungal nail infection

A

Dermatophytes - trichophyton rubrun in 90% of cases

112
Q

Causes of fungal nail infection

A

1) Dermatophytes - trichophyton rubrun in 90% of cases

2) Yeasts - candida

113
Q

Treatment of candida fungal nail infections

A

Topical antifungal if mild

oral itraconazole for 12 months

114
Q

Treatment of dermatophyte fungal nail infection

A

Oral terbinafine
Up to 3 months
Successful in 50-80%

115
Q

What causes seborrhoeic dermatitis?

A

Inflammatory reaction to malassezie furfur

116
Q

Seborrhoeic dermatitis - associated conditions

A

HIV

Parkinson’s disease

117
Q

Seborrhoeic dermatitis - 1st line management of scalp disease

A

Head and shoulders

Tar

118
Q

Seborrhoeic dermatitis - 2nd line management of scalp disease

A

ketoconazole

119
Q

Seborrhoeic dermatitis - management of face and body disease

A

Topical antifungals - ketoconazole

Topical steroids

120
Q

Seborrhoeic dermatitis in children - management

A

Baby shampoo and oils

Mild topical steroids 1% hydrocort

121
Q

Seborrhoeic dermatitis in children - presentation

A

Craddle cap

Resolves spontaneously by 8 months

122
Q

What worsens psoriasis?

A 
Skin trauma
Stress
Streptococcoal infection
Alcohol
Withdrawing steroids
Drugs
123
Q

What drugs worsen psoriasis?

A 
Beta blockers
Lithium
Antimalarials
NSAIDS
ACEI
Infliximab
124
Q

1st line management of psoriasis

A

Potent corticosteroids OD + vitamin D analogue OD for up to 4 weeks

125
Q

2nd line management of psoriasis

A

Vitamin D analogue BD

126
Q

3rd line management of psoriasis

A

Potent corticosteroids BD for up to 4 weeks OR coal tar

127
Q

Examples of vitamin D analogues

A

Calcipotriol
Calcitriol
Tacalcitol

128
Q

1st line management of scalp psoriasis

A

Potential topical corticosteroid for 4 weeks

129
Q

2nd line management of scalp psoriasis

A

Different formulation of steroid + topical agent to remove scale (eg. salicylic acid) before applying steroid

130
Q

Management of face/flexural/genital psoriasis

A

Mild/mod steroid OD/BD for 2 weeks

131
Q

Phototherapy options for managing psoriasis

A

Narrow band UVB

Psorlaen + UVA (PUVA)

132
Q

Systemic therapy options for managing psoriasis

A

Oral methotrexate
Ciclosporin
Systemic retinoids
Infliximab

133
Q

What triggers guttate psoriasis?

A

Strep

134
Q

Features of pityriasis rosea

A

Herald patch on trunk

THEN erythematous, oval, scaly patches which follow characteristic distribution “fir tree appearance”

135
Q

Management of pityriasis rosea

A

Self limiting

Resolves in 6-12 weeks

136
Q

Treatment for tinea corpis

A

oral fluconazole

137
Q

Presentation of tinea capitis

A

Scarring alopecia

Untreated may cause kerion (raised, pustular, boggy mass)

138
Q

Management of tinea capitis

A 
Oral antifungals (terbinafine or griseofulvin)
Topical ketoconazole
139
Q

What is bullous pemphigoid?

A

Autoimmune condition causing sub-epidermal blistering

140
Q

Features of bullous pemphigoid

A

Elderly patients
Itchy, intense blisters around flexures
Blisters heal without scarring
No mucosal involvement

141
Q

Management of bullous pemphigoid

A

Oral steroids
Topical steroids
Immunosuppression
Antibiotics

142
Q

What is pemphigus vulgaris?

A

Autoimmune disease causing skin blistering and mucosal ulceration

143
Q

Features of pemphigus vulgaris

A

Mucosal ulceration
Skin blistering - flaccid, easily ruptured
Lesions painful but not itchy
Nikolsky’s sign

144
Q

Management of pemphigus vulgaris

A

steroids

immunosuppression

145
Q

School exclusion in molluscum contagiosum?

A

Not needed

146
Q

Management of molluscum contagiosum

A

Advise not to share towels, clothing or baths
Will self-resolve within 18 months

Can try to squeeze/pierce lesions
Cryotherapy

147
Q

Molluscum contagiosum - who to refer?

A

HIV positive and extensive lesions
Eyelid margin or ocular lesion
Adults with anogenital lesions for STI screening

148
Q

What is pityriasis versicolour?

A

Superficial cutaneous infection caused by malassezia furfur

149
Q

Features of pityriasis versicolour

A 
On trunk
Patches may be hypopigmented, pink or brown
May be more noticeable with suntan
Scale is common
Mild pruritis
150
Q

Management of pityriasis versicolour

A

Ketoconazole shampoo

If doesn’t respond then send skin scrapings to confirm diagnosis and oral itraconazole

151
Q

Pyogenic granuloma - features

A

Initially red/brown spot
Rapid progression to raised, spherical lesion
Lesions may bleed profusely or ulcerate

152
Q

Pyogenic granuloma - management

A

Lesions associated with pregnancy resolve after pregnancy

Curettage + cauterisation
Cryotherapy
Excision

153
Q

Pyoderma gangrenosum - causes

A 
IBD
RA
SLE
Myeloproliferative disorders, lymphoma, leukaemia
Primary biliary cirrhosis
154
Q

Pyoderma gangrenosum - features

A 
Lower limbs 
Initially small red papule
Becomes a deep red necrotic ulcer 
Ulcer has violaceous border
May have systemic features
155
Q

Pyoderma gangrenosum - management

A

High risk of rapid progression

1st line: oral steroids

2nd line: other immunosuppressants e.g. ciclosporin, infliximab

156
Q

What is pompholyx?

A

Type of eczema that affects hands and feet

157
Q

Pompholyx - presentation

A

Blisters on palms and soles
Intensely itchy
Blisters may burst to become dry, cracked ski

158
Q

Pompholyx - management

A

Cool compresses
Emollients
Topical steroids

159
Q

Porphyria cutanea tarda - features

A

Photosensitive rash with blistering
Skin fragility
Hypertrichosis
Hyperpigmentation

160
Q

Porphyria cutanea tarda - management

A

Chloroquine

Venesection if ferritin >600

161
Q

Management of shingles

A

Analgesia - simple, then amitriptylline, then steroids if severe pain in first 2 weeks

Antivirals - within 72h unless <50y with mild rash only, reduces post hepatic neuralgia

162
Q

Drugs that cause Stevens-Johnson Syndrome

A 
Penicillin
Sulphonamides
Lamotrigine, carbamazepine, phenytoin
Allopurinol
NSAIDS
Oral contraceptive pill
163
Q

Features of Stevens-Johnson Syndrome

A

Maculopapular rash with vesicles and bulae
Mucosal involvement
Systemically unwell with fever and arthralgia

164
Q

Drugs that cause of Toxic Epidermal Necrosis

A 
Phenytoin
Sulphonamides
Allopurinol
Penicillins
Carbamazepine
NSAIDS
165
Q

Features of Toxic Epidermal Necrosis

A

Blistering and peeling of the skin
Mucosal involvement
Systemically unwell (very)
Positive Nikolsyk’s sign

166
Q

Who gets Zoon’s balanitis?

A

Uncircumcised middle aged/elderly men

167
Q

Features of Zoon’s balanitis

A

Erythematous, well demarcated shiny patches which affect head of the penis

168
Q

Zoon’s balanitis management

A

Circumcision is curative

169
Q

Rosacea - features

A 
Flushing
Telangiectasis
Persistent erythema with papules and pustules
Sunlight exacerbates symptoms
Rhinophyma
170
Q

Rosacea - 1st line management

A

Topical metronidazole

171
Q

Rosea - 2nd line management

A

Oral oxytetracycline

172
Q

What is dermatitis herpetiformis?

A

Autoimmune blistering condition associated with coeliac’s disease

173
Q

Management of dermatitis herpetiformis

A

Gluten free diet

Dapsone

174
Q

Features of erythema multiforme

A

Target lesions

175
Q

Causes of erythema multiforme

A 
Herpes simplex
Orf
Mycoplasma, streptococcus
SLE
Sarcoidosis
Malignancy
Drugs - penicillin, carbamazepine, allopurinol, NSAIDS, oral contraceptive
176
Q

What is erythema multiforme major?

A

Severe form with mucosal involvement

177
Q

What is acral lentiginosus?

A

Rare malignant melanoma form
Nails, palms, soles
Seen in Asians and African Americans

178
Q

What is lentigo maligna?

A

Less common malignant melanoma
Seen in chronically sun exposed older people
A growing mold

179
Q

Most common type of malignant melanoma?

A

Superficial spreading

180
Q

Diagnostic features for melanoma - major features

A

Change in size
Change in shape
Change in colour

181
Q

Diagnostic features in malignant melanoma - minor features

A

Diameter >7mm
Inflammation
Oozing and bleeding
Altered sensation

182
Q

Malignant melanoma - what determines prognosis?

A

Breslow depth

183
Q

Squamous cell carcinoma - risk factors

A 
Excessive sunlight
UVA phototherapy
Actinic keratoses and Bowen's disease
Immunosuppression
Smoking
Long standing leg ulcers
184
Q

Squamous cell carcinoma - management

A

Surgical excission

185
Q

Squamous cell carcinoma - good prognostic factors

A

Well differentiated tumours
<20mm diameter
<2mm depth
No associated diseases

186
Q

Squamous cell carcinoma - poor prognostic factors

A

Poorly differentiated tumours
>20mm diameter
>4mm depth
Immunosuppression

187
Q

What is Bowen’s disease?

A

Pre-cancerous skin lesion
Percursor to SCC
10% change of cancer if left untreated

188
Q

Features of Bowen’s disease

A

Red, scaly patches on sun exposed sites

189
Q

Management of Bowen’s disease

A

Topical 5-fluorouracil (use topical steroids if significant inflammation)
Cyrotherapy
Excision

190
Q

Features of basal cell carcinoma

A

“rodent ulcers”
Pearly flesh coloured papules with tenalgiectasis
Ulcerate causing central crater

191
Q

Management of basal cell carcinoma

A

Surgical removal
Curettage
Cyrotherapy

192
Q

Referral timeline for basal cell carcinoma

A

Routine

193
Q

Referral timeline for squamous cell carcinoma

A

Urgent

194
Q

What is actinic keratoses?

A

Premalignant skin changes

195
Q

Actinic keratoses - features

A

Small, crusty or scaly lesions
Pink, red, brown or skin colour
Sun exposed sites
May have multiple

196
Q

Actinic keratoses - management

A

Fluorouracil cream (steroids if skin becomes very inflammed)
Topical diclofenac if mild
Topical imiquimod
Cryotherapy

197
Q

Bacteria seen in acne

A

Propionibacterium acnes

198
Q

What percentage of adolescents get acne?

A

80-90%

60% seek advice

199
Q

What percentage of adults get acne?

A

10-15% women over 25

5% men over 25

200
Q

Management of acne vulgaris - step 1

A

Single topical therapy - topical retinoids or benzyl peroxide

201
Q

Management of acne vulgaris - step 2

A

Topical antibiotic

+ topical retinoid or benzyl peroxide

202
Q

Management of acne vulgaris - step 3

A

Oral antibiotic PLUS topical retinoid or benzyl peroxide

  • lymecycline, doxycycline
  • erythromycin in pregnancy

OR try oral contraceptive in women

203
Q

Management of acne vulgaris - step 4

A

Oral isotretinoin

204
Q

Superficial epidermal burn appearance

A

Red and painful

205
Q

Partial thickness (superficial dermal) burn appearance

A

Pale pink, painful, blistered

206
Q

Partial thickness (deep dermal) burn appearance

A

Typically white, may have patches of non-blanching erythema, reduced sensation

207
Q

Full thickness burn appearance

A

White/brown/black
No blisters
No pain

208
Q

Which oral contraceptive to prescribe women to treat acne?

A

Dianette (co-cyrindiol)

209
Q

Which of bullous pemphigoid and pemphigus vulgaris has mucosal involvement?

A

Pemphigus vulgaris

210
Q

What is erythrasma?

How is it treated?

A

Flat, slightly scaly pink or brown rash in the groin or axillae

Treat with topical micondazole or antibiotic

211
Q

Lichen sclerosus - presentation

A

White plaques on dermis
Genitalia
Very itchy

212
Q

Lichen sclerosus - management

A

Topical steroids and emollients

213
Q

Management of oral lichen planus

A

Benzydamine mouthwash

214
Q

Common sites for keloid scars in order

A

1) sternum
2) shoulder
3) neck
4) face
5) extensor surface of limbs
6) trunk

215
Q

Treatment of keloid scars

A

Early - intra-lesional steroids

Excision

216
Q

What does a tight white ring around tip of foreskin and phimosis suggest?

A

Lichen sclerosis

217
Q

Which antibiotic should not be co-prescribed with oral isotretinoin?

A

Tetracyclines due to risk of benign intracranial hypertension

218
Q

What is oral linchen planus called?

A

Wickham’s striae

219
Q

What is granuloma inguinale (donovanosis)?

A

STI caused by klebsiella granulomatosis

220
Q

When to suspect granuloma inguinale (donovanosis)?

A

Enlarging ulcer that bleeds in the inguinal area

221
Q

What is the risk with erythma ab igne?

A

Untreated may cause squamous cell cancer

222
Q

Treatment of strawberry naevus

A

Not normally needed as 95% resolve by age 10

Propranolol

223
Q

What is keratoderma blenorrhagica?

A

Waxy yellow/brown papules on palms and soles

224
Q

How many fingertip units needed for hand and fingers?

A

1

225
Q

How many fingertip units needed for a foot?

A

2

226
Q

How many fingertip units needed for front of chest and abdomen

A

7

227
Q

How many fingertip units needed for back and buttocks

A

7

228
Q

How many fingertip units needed for face and neck

A

2.5

229
Q

How many fingertip units needed for entire arm and hand

A

4

230
Q

How many fingertip units needed for entire leg and foot

A

8

231
Q

What is a fingertip unit?

A

0.5g

Enough to treat a skin area about twice that of a flat of an adult hand

232
Q

Management of venous ulcers

A

Compression bandaging

Oral pentoxifylline, a peripheral vasodilator

233
Q

ABPI >1.2

A

Calcified, stiff arteries

Seen in advanced age or PAD

234
Q

ABPI 1.0-1.2

A

Normal

235
Q

ABPI 0.9-1.0

A

Acceptable

236
Q

ABPI <0.9

A

Likely PAD

237
Q

ABPI <0.5

A

Severe PAD, refer urgently

238
Q

At what ABPI is compression bandaging considered acceptable?

A

ABPI ≥ 0.8

239
Q

Best first line management for tinea capitis

A

Oral terbinafine with topical ketoconazole shampoo for the first 2 weeks

240
Q

When should a patient with guttate psoriasis be urgently referred for phototherapy?

A

if >10% of body surface area affected

241
Q

What is notalgia paraesthetica?

A

Chronic itch on medial border of scapula

242
Q

Atopic eruption of pregnancy

A

Eczematous, itchy red rash

No specific treatment needed

243
Q

Polymorphic eruption of pregnancy

A

Pruritic condition in the 3rd trimester
Lesions in abdominal striae
Management = emollients, mild potency topical steroids, oral steroids

244
Q

Pemphigoid gestationis

A

Pruritic blistering lesions
Often in peri-umbilical region before spreading
Rarely in first pregnancy
Needs oral steroids

245
Q

Skin disorders in SLE

A

Photosensitivity butterfly rash
Discoid lupus
Alopecia
Livedo reticularis

246
Q

What is juvenile spring eruption?

A

Itchy red rash of small bumps on tops of ears after sun exposure

247
Q

Management of juvenile spring eruption

A

Suncream, hats
Emollients
Calamine lotion
Antihistamines

In severe cases with painful blisters and crusts may need oral steroids or immunosuppression (should do ANA and ENA to rule out lupus)

248
Q

Causes of impetigo

A

staphylococcus aureus

Streptococcus pyogenes

249
Q

Impetigo - management of local disease

A

1st: 1% hydrogen peroxide
2nd: topical fusidic acid
3rd: topical mupirocin if MRSA

250
Q

Impetigo - management in extensive disease

A

Oral flucloxacillin

Oral erythromycin if penicillin allergic

251
Q

Management of hidradenitis suppurativa acute flares

A

Oral/intralesional steroids
Flucloxacillin
I+D

252
Q

Management of hidradenitis suppurativa long term disease

A

Topical clindamycin

Oral lymecycline/clindamycin/rifampicin

253
Q

What factors predispose to developing pressure ulcers?

A

Malnourishment
Incontinence
Lack of mobility
Pain

254
Q

Which scoring system is used to identify patients at risk of pressure ulcers?

A

Waterlow score

255
Q

What is grade 1 pressure score?

A

Non-blanching erythema

Skin is intact

256
Q

What is a grade 2 pressure sore?

A

Partial thickness skin loss involving epidermis or dermis or both
Ulcer is superficial

257
Q

What is a grade 3 pressure sore?

A

Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to underlying fascia

258
Q

What is a grade 4 pressure sore?

A

Extensive destruction, tissue necrosis

Damage to muscle or bone

AKT (20 decks)

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